Frequently asked questions

The Need for Measure N

Why is Measure N needed?

Major earthquakes have caused many California hospitals to suffer significant damage, killing patients and forcing them to suspend some or all services. In response, the state legislature approved Senate Bill 1953 (SB 1953) requiring every California hospital to meet stringent seismic safety standards or risk closure. The ultimate public safety benefit of the bill is to have general acute care hospitals and emergency rooms that are built to remain fully operational 24/7 after a seismic event. Our hospital does not meet these standards. Measure N will provide the funds needed to upgrade the facilities by building a new seismically safe hospital for our community.

Are we really at risk of having the hospital closed if we don’t meet the seismic safety standards?

Yes. A hospital that does not meet SB 1953’s structural and nonstructural requirements “shall not provide acute care services or beds” after the 2030 compliance deadline. And acute care includes the emergency room.

Mariposa County is not in a major earthquake zone, so why do we need to meet such strict seismic standards? Have we tried to get exempted from this “one size fits all” law?

Yes, and our repeated efforts to be exempted or to meet less stringent requirements have all been rejected. There is proposed legislation (Senate Bill 758) that would extend the current 2030 deadline by seven years, giving hospitals like ours more time to comply with the seismic safety standards. But our hospital will need to comply eventually, and building sooner affords two major benefits. One is that with construction costs constantly rising, the total cost will be less. The second is that the sooner it’s built, the sooner our community reaps the rewards of having a larger emergency room, an operating room, more advanced and accessible diagnostic equipment, better accommodations in private rooms, and all the other improvements that accompany having a modern, state-of-the-art hospital.

The closures and restrictions caused by the pandemic are really hurting our tourism-based economy. Wouldn’t it be better to delay the project until our local economy is stronger?

Most epidemiologists expect vaccines and better treatments to be available during the first half of next year, and some even predict a vaccine will be available by the first of the year. These developments should help get the pandemic under control by the time the tax takes effect on April 1 ST 2021, enabling both the global and local economies to open even more. We are already partially open here in Mariposa County, and it is reasonable to expect that next year will be much better than this one has been. Just as important is the cost of waiting. Because a project of this magnitude (no pub intended) will take many years to complete, a delay will only increase the total cost.

Use of Measure N Funds

What will Measure N do?

Measure N will provide the funds needed to upgrade the facilities by building a new, seismically safe hospital for our community. The new facilities will:

  • Ensure that our hospital and its Emergency Room will stay open and fully operational during any natural disaster to provide essential medical care 24/7
  • Expand and modernize the Emergency Room to reduce wait times, create space for large diagnostic equipment and otherwise improve patient care
  • Replace outdated medical equipment with modern, state-of-the-art technology, including both diagnostic and support equipment, to meet the operating needs of the hospital
  • Build facilities essential to attract and retain the highly qualified medical professionals needed to serve our community
How much funding is Measure N expected to raise?

A 1% sales tax will raise approximately $2,600,000 annually. It is important to note that about one-third of Mariposa County’s total sales tax receipts come from purchases made by tourists in Yosemite.

Why not just renovate the existing hospital?

The hospital Board of Directors has given this and other options careful consideration, including in consultation with other healthcare districts, and professional architects and engineers specializing in hospitals. But because the hospital was built almost 70 years ago, even a major and potentially very costly renovation would not meet all of the hospital’s safety and patient care needs. There will be ways, however, to repurpose the existing hospital for other needs (see question below).

Why not just build a new emergency room next to the existing hospital?

That is simply not an option anywhere in California, where emergency rooms must be part of acute care hospitals that provide a full range of healthcare and related services. According to Senate Bill 687, the State Department of Public Health “shall not license a stand-alone emergency room, freestanding emergency department, or freestanding emergency center that is not part of a general acute care hospital facility providing 24-hour inpatient care with basic services, including, but not limited to, medical, nursing, surgical, anesthesia, laboratory, radiology, pharmacy, and dietary services.” And as noted previously, the entire facility must meet California’s strict seismic safety standards.

What is the district planning to build?

The District will build a new hospital that meets the strict seismic safety standards required state law. The new hospital, to be built on existing campus next to the current hospital, will include an expanded and enhanced emergency room with enough beds to reduce wait times significantly, a surgical suite with a recovery area, easily accessible diagnostic equipment, more individual patient rooms with adjoining private bathrooms, a new lab, a pharmacy, and many other useful amenities. To ensure the new facility meets the community’s needs, the hospital staff will have an opportunity to provide input during the design phase.

Why are there not any architectural drawings of the new hospital?

One of the most important measures of success of a building is whether it satisfies the needs of the people who will use it. Therefore, the first step for an architect is to interview the doctors, nurses, specialists and other staff who work in patient care, food service, housekeeping and maintenance to design the building to best suit their needs. Only after the architect thoroughly understands the needs, and works with the builder make cost-saving adjustments, can the drawings be made and presented to the public. This process, also to be funded by Measure N, ensures that the hospital will meet the requirements of the community and keeps expensive change orders to a minimum.

When will the new hospital be built?

If Measure N passes, initial planning for design specifications and working drawings will begin immediately. The whole process of design and construction will take several years, leaving adequate time to have the new hospital be up and running before the 2030 deadline.

What will happen with the existing buildings?

They can be repurposed for many potential uses, and those be will determined during the design phase of the new hospital. For example, the primary care clinic was built in 1996 to the standards required for clinics at that time, and it will probably remain a clinic. Existing facilities could also be used to expand the Ewing Wing, for administrative offices or some other purpose that might be identified.

How much is the total project expected to cost?

That will not be known until the plans are finalized. But what is known now is that similar healthcare districts serving similar communities have spent between $50 million and $80 million on new seismically safe hospitals

How can I be assured the district is going to invest this money wisely?

This money is earmarked 100% for construction of a new replacement hospital. It will be used to secure a bond, and all phases of the project will be subject to an open, public process.

The hospital has struggled under poor management in the past. How can I be assured that won’t be the case for the new hospital?

The hospital’s finances are audited by an impartial outside firm of experts every year, and the resulting report is public information that is posted on the District’s website. Mariposa County residents are encouraged to read the auditor’s report to learn how the District’s funds are allocated. The financial situation improved substantially when the District recruited experienced professionals in key administrative positions several years ago. The District was criticized at the time for using “outsiders” rather than Mariposans. But the fact is: running a hospital takes special talent, and having that talent here has made the John C. Fremont Hospital a well-run operation. The prudent fiscal management has also enabled the hospital to expand services, recruit more specialists and reduced turn-over by boosting employee morale.

I live closer to other emergency rooms. Why should I vote for Measure N?

For most Mariposa County residents, John C. Fremont Hospital is the closest emergency room while they are at home, at work or running errands. And in an emergency, whenever and wherever it strikes, minutes can mean the difference between life and death. But the hospital is much more than just its emergency room, and the District will be expanding and enhancing its offering of medical services as part of the construction of the new hospital. These improvements will give residents from throughout the county more options for both routine and specialized medical care. Of course, residents who live closer to hospitals in neighboring counties may also shop more frequently at stores in those neighboring counties, and will not be paying the Mariposa County sales tax when they do.

When will the clinic in Greeley Hill be reopened?

Reopening the Greeley Hill Clinic on the Northside, which was destroyed in a fire, is a priority for the District. The property has since been sold, and the District has already signed a lease with the new owners. Construction is underway and the building is expected to be approved for occupancy around the time of the election.

Why a Sales Tax

Why did the hospital’s Board of Directors choose a sales tax instead of a property tax?
Why not just tax the tourists with an increase in the bed tax?
How much do you expect the average resident will pay in additional taxes if Measure N passes?
The hospital’s financial position seems strong, so why is additional funding needed to build a new hospital?
How do other rural hospitals fund building new facilities?
Has the District tried to get grant money that might be available for rural healthcare districts?
Why is there no sunset clause in Measure N like there is for the previous measure?
Because the hospital already gets a 1⁄2% sales tax supplement, Measure N will make the total 11⁄2%. Does the hospital really need that much funding in taxes?
How does an 8.75% sales taxes compare to other communities in California?
Is John C. Fremont a county hospital?
What is a Healthcare District?
Then why was it necessary to involve the Board of Supervisors?
Can funds raised by Measure N be taken away by Mariposa County or the state of California to be used for other purposes?
When is the election and how can I safely submit my ballot?
Where can I go for more information?